RISK OF DEVELOPING AIDS AFTER PRIMARY ACUTE HIV-1 INFECTION

We enrolled 134 newly human immunodeficiency virus type 1 (HIV-1)-infe cted subjects in a prospective study to determine the natural history of the infection and evaluate the risk of developing AIDS after acute primary HIV-1 infection (API). Twenty-three patients were observed dur ing an acute primary HIV-1 infection, and Ill were asymptomatic seroco nverters. Acute primary HIV-1 infection was more frequently observed i n subjects who had acquired the infection through sexual transmission. Intravenous drug users were rarely affected and presented with milder symptomatology. Patients observed with an acute primary HIV-1 infecti on had a significantly higher risk of developing AIDS than asymptomati c seroconverters (68% at 56 months vs. 20% at 66 months; p = 0.026). L ow CD4+ cell counts at the onset of acute illness and delayed seroconv ersion in enzyme-linked immunosorbent assay (ELISA) were associated wi th evolution to AIDS in acute seroconverters (p = 0.03 and 0.02, respe ctively). During the follow-up, patients with an acute illness were mo re likely to show an early fall of CD4+ cell counts below 200/mul than asymptomatic seroconverters. The results of this follow-up study sugg est the opportunity to study antiviral treatment protocols in patients with API as a possible measure to control disease progression.